The aim of the Principal Research Core (PRC) is to build the Center's capacity to facilitate the testing of interventions for middle-aged and elderly patients with schizophrenia and other psychotic disorders. The goal of such capacity building is to increase the number of evidence-based interventions applicable to community care. We will use different intervention approaches (preventive, treatment, and rehabilitative), with the focus being on the following themes: (I) Reducing psychopathology (including primary deficits such as positive symptoms, negative symptoms, and cognitive impairment, depressive symptoms with suicidability, and functional impairment), (II) Reducing physical comorbidities (both age-associated and itrogenic), (III) Optimizing health behaviors (especially, reducing substance use and increasing medication adherence), and (IV) Minimizing healthcare disparities (e.g., among Latino and other ethnic minority groups). Our prior work over the past decade included a number of pharmacologic intervention trials targeted to older patients with psychotic disorders. During the past 3 years, our group has developed manualized cognitive and behavioral interventions for this patient population. Our recent studies have highlighted under-treatment of physical comorbidity in older psychosis patients along with ethnic and other disparities in the utilization of mental healthcare services in the San Diego County public mental health system. Our proposed work in the PRC will incorporate pharmacologic, psychosocial, and services interventions. To illustrate this process, we have selected seven examples of pilot projects relevant to the Center themes, including community-dwelling middle-aged and elderly persons with schizophrenia, and involving: (1) Delivery of manualized cognitive behavioral social skills training with therapists from community settings, (2) Citalopram augmentation of anti-psychotic treatment to reduce suicidality, (3) Vocational rehabilitation, (4) Healthcare case management for older homeless patients with psychosis, (5) A multi-pronged smoking cessation intervention, (6) Medication adherence therapy for anti-psychotic and selected non-psychotropic medications, and (7) Cross-cultural needs assessment using qualitative and quantitative methods. A critical component of our work will be a close two-way partnership with community stakeholders including patients, caregivers, care providers, and payers throughout the development and execution of research projects. With the help of our collaborators in the community, we propose to implement and disseminate successful treatment strategies for use in community settings.